Mad in America: Rethinking Mental Health

On MIA Radio this week, in the first of a number of podcasts focussed on parenting issues, we interview Dr. Craig Wiener, a licensed psychologist based in Worcester, Massachusetts, who specializes in the treatment of children, adolescents, and families. In addition to over 30 years of private practice, Dr. Wiener is an assistant professor in the Department of Family Medicine and Community Health at the University of Massachusetts Medical School. Dr. Wiener is the author of three books. most recently Parenting Your Child with ADHD: A No-Nonsense Guide for Nurturing Self-Reliance and Cooperation. Earlier this year he debuted his three-part video series "ADHD: A Return to Psychology," which appears on the Mad in America website and also on YouTube. © Mad in America 2019

Pat Bracken is a psychiatrist who questions many of the fundamental assumptions of his field. He has worked as a psychiatrist in rural Ireland, inner-city and multi-ethnic parts of the UK, and in Uganda, East Africa. Bracken, who holds doctoral degrees in both medicine and philosophy, calls for a movement toward critical psychiatry. He was one of the people involved in starting the Critical Psychiatry Network, an organization of psychiatrists, researchers, and mental health professionals that question the assumptions that lie beneath psychiatric knowledge and practice. Through his clinical practice and his academic work in philosophy and ethics, he has seen the limits and dangers of standard approaches to mental health in the West. As a result, he has become an advocate for listening to different understandings of madness from those who are routinely ignored and dismissed — namely, service-users and people who themselves experience madness, and those from indigenous and non-Western cultures.

MIA's Ayurdhi Dhar interviews Diana Kopua about the Mahi a Atua approach, the global mental health movement, and the importance of language and narratives in how we understand our world and ease our suffering. Diana Kopua's life resembles the stories she uses in her work. From a psychiatric community nurse to the head of the department of psychiatry for Hauora Tairawhiti in Gisborne, New Zealand, her 13-year long, arduous journey is both deeply personal and profoundly political. Kopua says she did this to "become a wedge that kept the door open to allow for indigenous leaders" in her world to change the system. One may call her a storyteller, but a story-gatherer might be more appropriate. As a psychiatrist, Kopua deals in human distress but her interest does not lie in neat psychiatric classifications; instead, she focuses on understanding suffering through Maori creation stories, Purakau. She has developed Mahi a Atua, "an engagement, an assessment, and an intervention" to address the mental distress and suffering among the Maori of New Zealand. Mahi a Atua is not just a set of techniques or a culturally sensitive new therapy, but a drastically different way of conceptualizing the lived experience of the Maori. Recently, along with art and culture expert Mark Kopua and critical psychiatrist Pat Bracken, she published a paper on this approach in Transcultural Psychiatry. Their work can be seen as an alternative to Western pharmaco-therapeutic interventions currently being promoted throughout the global South via the global mental health movement. Researchers have critiqued the exporting of Western psychiatric practices, often citing the famous WHO study that reported better outcomes for people diagnosed with mental disorders in the developing world. As the only Ngati Porou (a Maori nation) psychiatrist in the world, working with a population known for poor mental health outcomes, Kopua's work offers insight into what can be learned from local, Indigenous, and traditional healing methods. There are many now calling for a "paradigm shift" in Western psychiatry, and in our interview, we covered topics ranging from the specifics of the Mahi a Atua approach, the global mental health movement, and the importance of language and narratives in how we understand our world and ease our suffering. © Mad in America 2019

This week on MIA Radio, we present a special episode of the MIA podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2019. 2019 represents the fourth annual awareness day and each year it's held on July 11 which is a significant date because it is the birthday of Professor Heather Ashton. Dr. Ashton is a world-leading expert in benzodiazepines and wrote the highly regarded Ashton Manual which aims to aid clinicians and patients in coming off benzodazepine drugs safely. She also spent many years personally assisting and supporting those who had experienced protracted benzodiazepine withdrawal. Around the world there are many activities and events taking place as part of W-BAD, so to follow along with events and to get involved yourself, head over to World Benzodiazepine Awareness Day's Facebook page and look out for the hashtag #WorldBenzoDay on social media. In our two-part podcast, we hear from W-BAD volunteer and Project Manager for W-BAD Rocks of Kindness, Janelle. We also chat with physician and Director of the Benzodiazepine Information Coalition Christy Huff MD. Finally, in part two, we hear from Stephen Wright MD, addiction specialist and medical consultant to the Alliance for Benzodiazepine Best Practices. W-BAD Rocks on Facebook Rockin' Against Benzos (closed Facebook group) A Rockin' Creative Outlet That's Raising Benzodiazepine Awareness #WBADROCKS – 1 Month, 5 Things We've Learned W-BAD Rocks on Twitter and Instagram: @wbadrocks On social media, look for the hashtag #WBADROCKS A Xanax Prescription That Should Have Been Rejected 10 Tips To Help Patients Through Benzodiazepine Withdrawal Follow Dr. Huff on Twitter Dr. Huff's Blogs and Media Appearances (Scroll down below her bio and click on logos) BIC on Facebook @bzinfocoalition BIC on Twitter @BZInfoCoalition The Alliance for Benzodiazepine Best Practices Benzodiazepine Related Problems: It's Almost Never Addiction Benzodiazepines and Z Drugs for Pain Patients: The Problem of Protracted Withdrawal Symptoms (PWS) How Chronic Administration of Benzodiazepines Leads to Unexplained Chronic Illnesses: A Hypothesis

This week on MIA Radio, we present a special episode of the MIA podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2019. 2019 represents the fourth annual awareness day and each year it's held on July 11 which is a significant date because it is the birthday of Professor Heather Ashton. Dr. Ashton is a world-leading expert in benzodiazepines and wrote the highly regarded Ashton Manual which aims to aid clinicians and patients in coming off benzodazepine drugs safely. She also spent many years personally assisting and supporting those who had experienced protracted benzodiazepine withdrawal. Around the world there are many activities and events taking place as part of W-BAD, so to follow along with events and to get involved yourself, head over to World Benzodiazepine Awareness Day's Facebook page and look out for the hashtag #WorldBenzoDay on social media. In our two-part podcast, we hear from W-BAD volunteer and Project Manager for W-BAD Rocks of Kindness, Janelle. We also chat with physician and Director of the Benzodiazepine Information Coalition Christy Huff MD. Finally, in part two, we hear from Stephen Wright MD, addiction specialist and medical consultant to the Alliance for Benzodiazepine Best Practices. W-BAD Rocks on Facebook Rockin' Against Benzos (closed Facebook group) A Rockin' Creative Outlet That's Raising Benzodiazepine Awareness #WBADROCKS – 1 Month, 5 Things We've Learned W-BAD Rocks on Twitter and Instagram: @wbadrocks On social media, look for the hashtag #WBADROCKS A Xanax Prescription That Should Have Been Rejected 10 Tips To Help Patients Through Benzodiazepine Withdrawal Follow Dr. Huff on Twitter Dr. Huff's Blogs and Media Appearances (Scroll down below her bio and click on logos) BIC on Facebook @bzinfocoalition BIC on Twitter @BZInfoCoalition The Alliance for Benzodiazepine Best Practices Benzodiazepine Related Problems: It's Almost Never Addiction Benzodiazepines and Z Drugs for Pain Patients: The Problem of Protracted Withdrawal Symptoms (PWS) How Chronic Administration of Benzodiazepines Leads to Unexplained Chronic Illnesses: A Hypothesis

Last year, Lucy Johnstone and her colleagues in the UK launched the Power Threat Meaning Framework (PTMF), a set of ideas that represented a sharp departure from the biomedical conceptions that animate the American Psychiatric Association's Diagnostic and Statistical Manual (DSM). This framework shifts the notion of "what is wrong with you" in the DSM to "what has happened to you," and by doing so turns away from a medical process bent on diagnosing broken brains and toward a narrative response that tells of contexts, power dynamics, and systems. At a time when the Movement for Global Mental Health is intent on exporting the Western biomedical approaches around the world, Johnstone and her PTMF team, which has included numerous individuals who identify as service users/survivors, are seeking to promote a radically different way of understanding distress. Responses to the PTMF have ranged the gamut from criticism to gratitude. Johnstone, a consulting clinical psychologist who has experience working in adult mental health settings for many years, believes that the current mental health system has failed, and we are now in the process of witnessing its inevitable downfall. She questions whether a mental health system is needed at all. However, as Thomas Kuhn wrote in his work on scientific revolutions, a system cannot be fully abandoned until there exists a conceptual alternative for the system to move towards. The PTMF, Johnstone believes, offers that conceptual alternative that is necessary for a revolution. In this interview, she reflects on the reaction to the PTMF, and the possibility that it will help stir up a revolution in the field. How is the framework to be used? Does it stand a chance of becoming adopted? She also tells of how her own life experiences and the influences on her work. Relevant Links Dr. Johnstone took part in an earlier interview after the PTMF was launched. You may view this interview here: https://www.madinamerica.com/2018/03/dr-lucy-johnstone-power-threat-meaning-framework/ More about the PTMF: Lucy Johnstone discussing the primary features of PTMF: https://www.youtube.com/watch?v=tkNWQdVB4F0 A British Psychological Society report (with full document link to the framework included): https://www.bps.org.uk/news-and-policy/introducing-power-threat-meaning-framework © Mad in America 2019

This week on MIA Radio, we continue our series of discussions with Doctor Lee Coleman. In previous podcasts, we have discussed Lee's views as a critical psychiatrist and the role of psychiatry in the courtroom. This time, we turn our attention to the need for action to address the inherent power held by psychiatry and how society might respond. In this episode we discuss: How language has the power to trigger associations and can lead us to not question theories that are presented to us as facts. How we have come to equate psychiatric 'treatment' with interventions in other areas of medicine. The deception behind the names of the drugs used in psychiatry such as 'antidepressants' or 'antipsychotics'. That society may well be blinded by language to the critical issues of the use of force and the relationship between the law and psychiatry. That, ultimately, society demands that psychiatry play the role that it does and therefore we need a societal and political response. That any movement to address the dominance of the medical model needs to educate the public at large and so needs resources to be able to provide that challenge. How the media often provides an amplified voice for mainstream messages leading to normalisation and lack of critical questioning of such messages. That we can and should partner with sympathetic media channels who are open to challenging mainstream messaging. That Lee will hopefully be leading a workshop at the 2019 NARPA (National Association for Rights Protection and Advocacy) Conference in Connecticut, USA. Relevant Links Article - Technology and Psychiatry NARPA 2019 Conference YouTube - Psychiatry's "War of the Words" YouTube - Dealing With Powerful Opponents: Psychiatry, Government and Pharma To get in touch, email us at podcasts@madinamerica.com © Mad in America 2019

On MIA Radio this week, MIA's Tim Beck interviewed Dr. Felicity Thomas and Dr. Richard Byng. Dr. Thomas is a Senior Research Fellow in the Medical School and a Senior Research Fellow on the Cultural Contexts of Health in the College of Humanities at the University of Exeter. She is also a co-director (with Professor Mark Jackson) of the WHO Collaborating Centre on Culture and Health and works closely with the WHO Regional Office for Europe project on the Cultural Contexts of Health. Dr. Byng is a professor in primary care research at the University of Plymouth. Dr. Byng is also trained as a general practitioner with a particular interest in mental health care. Over the last 20 years, he has worked on various large-scale research projects related to access, commissioning, inter-professional working and implementation of evidence-based practice, while publishing extensively on topics related to the social contexts of health and professional care. Together, Dr. Thomas and Dr. Byng have contributed to the DeSTRESS project, which consists of a team of researchers in the United Kingdom who seek to learn about why and how poverty-related issues have become increasingly pathologized. This includes exploring how high levels of antidepressant prescription and use are impacting people's health and wellbeing in low-income communities in southwest England. Their final report published in April 2019, entitled Poverty, Pathology, and Pills, situates increasing rates of mental health diagnosis and psychiatric prescriptions within socioeconomic and policy trends across the UK. An overarching conclusion of this research was that there is a need to reconceptualize the way that health professionals respond to poverty-related distress. This requires a response that recognizes the bio-psycho-social and reduces pressures on general practitioners (GPs) to make rapid decisions around diagnosing and prescribing.

On MIA Radio this week, MIA's Gavin Crowell-Williamson interviewed Adriane Fugh-Berman, MD, a professor in the Department of Pharmacology and Physiology and in the Department of Family Medicine at Georgetown University Medical Center (GUMC). She is the director of PharmedOut, a GUMC research and education project promoting rational prescribing and exposing the effects of pharmaceutical marketing on prescribing practices. Dr. Fugh-Berman leads a team of volunteer professionals that has deeply impacted prescribers' perceptions of the adverse consequences of industry marketing. She is interested in physician-industry relationships and is an expert witness in litigation regarding pharmaceutical marketing processes. She was formerly a medical officer in the Contraception and Reproductive Health Branch of the National Institute for Child Health and Human Development. Dr. Fugh-Berman is the lead author on key articles on physician-industry relationships, including a national survey of industry interactions with family medicine residencies, exposés of how ghostwritten articles in the medical literature are used to sell drugs, an analysis of drug rep tactics, and an explanation of industry publication planning. She wrote the first chapter on alternative medicine to appear in Harrison's Principles of Internal Medicine and authored the first clinicians' reference text on dietary supplements, the 5-Minute Herb and Dietary Supplement Consult, as well as an evidence-based book aimed at consumers, Alternative Medicine: What Works. In addition to dozens of articles in peer-reviewed literature, Dr. Fugh-Berman coauthored The Truth about Hormone Therapy and co-edited The Teratology Primer. Dr. Fugh-Berman is the former chair of and currently writes a column for the National Women's Health Network, a consumer advocacy group that takes no money from industry. Dr. Fugh-Berman has appeared on 20/20, the Today Show, and every major news network.

On MIA Radio this week, MIA's Peter Simons interviewed David Cohen, PhD, a social worker, professor of social welfare, and Associate Dean for Research at the Luskin School of Public Affairs of the University of California, Los Angeles. He discussed his path to becoming a researcher focused on mental health, coercive practices, and discontinuation from psychiatric drugs. He studies the social construction of psychoactive drug effects, the union of law and psychiatry within a criminalization/medicalization system and envisions alternatives to the current mental health industrial complex and the medicalization of everyday life. He has also taught in Canada and France, and for over 20 years held a private practice to help people withdraw from psychiatric drugs. He is the author of over 100 book chapters and articles. His first book, published in 1990, was Challenging the Therapeutic State: Critical Perspectives on Psychiatry and the Mental Health System. His latest book, published in 2013, with colleagues, Stuart Kirk, and Tomi Gomory is Mad Science: Psychiatric Coercion, Diagnosis and Drugs.